title: Long-term outcome of endovascular repair of popliteal artery aneurysm presents a credible alternative to open surgery.
abstract: OBJECTIVE
  Endovascular repair of popliteal artery aneurysms (PAA) has become increasingly popular; however, long-term patency and limb salvage rates are not fully established.
  
  
  METHODS
  A retrospective review of all endovascular PAA repairs at our institution (from 2005 to 2012) identified 34 PAAs in 26 patients, of which 32 % presented with acute symptoms. PAA were repaired with either Hemobahn(®) or Viabahn(®) endografts, using an entirely percutaneous approach. All patients were given Clopidogrel and/or aspirin postoperatively. Mean follow-up duration was 40 (range 4-86) months. Kaplan-Meier analysis was used to determine primary patency, secondary patency, and limb salvage rates. Complications and reintervention rates also were examined.
  
  
  RESULTS
  At 1, 3, and 5 years follow-up, the primary graft patency was 88, 82, and 82 %, respectively, and secondary patency was 90, 86, and 86 %. Amputation-free survival at 1, 3, and 5 years was 97, 94, and 94 %, respectively. Technical success was achieved in 100 %. There were five graft occlusions: one was asymptomatic, one was treated with thrombolysis successfully, and one was thrombolysed but reoccluded resulting in nondisabling claudication. Two were not suitable for thrombolysis and required amputation. The overall reintervention rate was 12 %.
  
  
  CONCLUSIONS
  The primary and secondary patency rates of endovascular repair of PAA are equivalent to the reported outcome of open repair. Reintervention and limb salvage rate appears better than open repair. With improved long-term outcomes, endovascular repair can be considered a credible treatment strategy for routine uncomplicated PAA.
authors.affiliation: Department of Vascular and Endovascular Surgery, The Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK, jhsaunders@doctors.org.uk.
authors.forename: John H
authors.initials: JH
authors.lastname: Saunders
authors.forename: Said
authors.initials: S
authors.lastname: Abisi
authors.forename: Nishath
authors.initials: N
authors.lastname: Altaf
authors.forename: Yao
authors.initials: Y
authors.lastname: Yong
authors.forename: Shane T
authors.initials: ST
authors.lastname: MacSweeney
authors.forename: Simon
authors.initials: S
authors.lastname: Whittaker
authors.forename: Said
authors.initials: S
authors.lastname: Habib
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery*; D000792:Angiography; D000925:Anticoagulants / Q000008:administration & dosage; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency
chemical_list: D000925:Anticoagulants